How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.05 Typical High $1.05 | Professional | None | $1.02 | $1.05 | $1.05 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Medica Setting Facility Modifier None Typical Low $1.07 Median $1.10 Typical High $2.40 | Facility | None | $1.07 | $1.10 | $2.40 |
Medica Setting Professional Modifier None Typical Low $0.63 Median $1.10 Typical High $8.71 | Professional | None | $0.63 | $1.10 | $8.71 |
United Setting Professional Modifier None Typical Low $0.50 Median $0.63 Typical High $1.10 | Professional | None | $0.50 | $0.63 | $1.10 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.11 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | A1 · Dressing, 1 wound | $1.78 | $1.78 | $1.78 |
Ambetter Setting Professional Modifier A2 · Dressing, 2 wounds Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | A2 · Dressing, 2 wounds | $1.35 | $1.35 | $1.35 |
Where Oklahoma sits
The same service costs 2.5 times more in Idaho than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oklahoma· 43rd of 51
$0.89
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.